Replica Form

THIS IS FOR REFERENCE ONLY [The Form must be submitted online only,filling in required details through the website of CBSE affiliation site]

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CENTRAL BOARD OF SECONDARY EDUCATION AFFILIATION OF SCHOOL

REGISTRATION PAGE Registration No: SS-00733-0708 You have successfully submitted Application On-line. kindly take the printout of this page and send the same along with Bank Draft (in favour of "Secretary, CBSE Delhi" , payable at Delhi) to " The Secretary, Central Board of Secondary Education, Shiksha Kendra, 2 Community Centre, Preet Vihar, Delhi 110092" for further processing. The application will be processed only after receipt of the Bank Draft and Registration Page on First Come First Served basis. Therefore, the documents may be sent so as to reach CBSE, Delhi immediately and , in any case, not later than 30th June 2006 in order to be eligible for affiliation for session 2007-08

School Name DELHI PUBLIC SCHOOL INDIRA NAGAR LUCKNOW

Head of the School ANU DHINGRA

Complete Mailing Address DELHI PUBLIC SCHOOL, SECTOR 19, INDIRA NAGAR, LUCKNOW,LUCKNOW,226016

District LUCKNOW

State UTTAR PRADESH

Applied For Upgradation to Senior Secondary Level LIST OF ENCLOSURES

1. NOC/Recognition Letter from State/UT or Recommendation from Embassy of India

yes

2.Land ownership documents for Authority yes

3. Copy of Registration letter of the trust/Society managing committee yes

4. Affidavit of Non-Proprietary Character of Society Yes

Details Of Bank Draft

Bank Draft No. 524700

Amount 10000

Date of Issue 5/20/2006

Name of the Issuing Bank Bank of Baroda

Address of the Issuing Bank BANK OF BARODA D BLOCK INDIRA NAGAR, LUCKNOW

CERTIFIED THAT T

The information provided is true to the best of my knowledge. The school is not sending candidates of any other Board/University for examination. The school is run by a registered society which is of a non-proprietary character and its constitution is such that it does not vest control in a single individual or members of a family and the aim of the society is to impart quality education to the children and not to earn profit.

Place: Signature & Seal

Date:

Principal

ANU DHINGRA

Counter Signed by President/Manager/Secretary/ Chairman of the Trust/Society

Signature with Stamp

Name & Designation MR. MUKHTARUL AMIN,PRESIDENT

Forwarded and Recommended

To be signed only in case NOC or separate letter is not enclosed. Director of Education State/UT, First Secretary Embassy of India in case of Signature with Stamp

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